Naomi Wolf, porn and the misuse of dopamine

‘Is pornography driving men crazy?’ asks campaigner Naomi Wolf in a CNNarticle that contains a spectacular misunderstanding of neuroscience applied to a shaky moral conclusion.

Wolf asks suggests that the widespread availability and consumption of pornography is “rewiring the male brain” and “causing them to have more difficulty controlling their impulses”.

According to her article, pornography causes “rapid densensitization” to sexual stimulation which is “desensitizing healthy young men to the erotic appeal of their own partners” and means “ordinary sexual images eventually lose their power, leading consumers to need images that break other taboos in other kinds of ways, in order to feel as good.”

Moreover, she says “some men (and women) have a “dopamine hole” – their brains’ reward systems are less efficient – making them more likely to become addicted to more extreme porn more easily.”

Wolf cites the function of dopamine to back up her argument and says this provides “an increasing body of scientific evidence” to support her ideas.

It does not, and unfortunately, Wolf clearly does not understand either the function or the relevance of the dopamine system to this process, but we’ll get onto that in the moment.

Purely on the premise of the article, I was troubled by the fact that “breaking taboos” is considered to be a form of pathology and it lumps any sort of progression in sexual interest as a move toward the “extreme”.

‘Taboo’ and ‘extreme’ are really not the issue here as both are a matter of perception and taste. What is important is ‘consensual’ and ‘non-consensual’ and when the evidence is examined as a whole there is no conclusive evidence that pornography increases sexual violence or the approval of it (cross-sectional studies tend to find a link, experimental and crime data studies do not).

To the contrary, wanting new and different sexual experiences is for the majority a healthy form of sexual exploration, whether that be through porn or other forms of sexual behaviour.

One part of the motivation for this is probably that people do indeed become densensitised to specific sexual images or activities, so seeing the same thing or doing the same thing over and over is likely to lead to boredom – as any women’s magazine will make abundantly clear on their advice pages.

But this is no different to densensitisation to any form of emotional experience. I contacted Jim Pfaus, the researcher mentioned in the article, who has conducted several unpublished studies showing that physiological arousal reduces on repeat viewing of sexual images, but he agrees that this is in line with standard habituation of arousal to most type of emotional images, not just sexual, that happens equally with men and with women.

It’s important to point out that this densensitisation research is almost always on the repetition of exactly the same images. We would clearly be in trouble if any sexual experience caused us to densensitise to sex as we’d likely lose all interest by our early twenties.

However, it is Wolf’s description of the dopamine system where things get really weird:

Since then, a great deal of data on the brain’s reward system has accumulated to explain this rewiring more concretely. We now know that porn delivers rewards to the male brain in the form of a short-term dopamine boost, which, for an hour or two afterwards, lifts men’s mood and makes them feel good in general. The neural circuitry is identical to that for other addictive triggers, such as gambling or cocaine.

The addictive potential is also identical: just as gamblers and cocaine users can become compulsive, needing to gamble or snort more and more to get the same dopamine boost, so can men consuming pornography become hooked. As with these other reward triggers, after the dopamine burst wears off, the consumer feels a letdown – irritable, anxious, and longing for the next fix.

Wolf is accidentally right when she says that porn ‘rewires the brain’ but as everything rewires the brain, this tells us nothing.

With regard to dopamine, it is indeed involved in sexual response, but this is not identical to the systems involved with gambling or cocaine as different rewards rely on different circuits in the brain – although doesn’t it sound great to lump those vices together?

Porn is portrayed as a dangerous addictive drug that hooks naive users and leads them into sexual depravity and dysfunction. The trouble is, if this is true (which by the way, it isn’t, research suggests both males and females find porn generally enhances their sex lives, it does not effect emotional closeness and it is not linked to risky sexual behaviours) it would also be true for sex itself which relies on, unsurprisingly, a remarkably similar dopamine reward system.

Furthermore, Wolf relies on a cartoon character version of the reward system where dopamine squirts are represented as the brain’s pleasurable pats on the back.

But the reward is not the dopamine. Dopamine is a neurochemical used for various types of signalling, none of which match the over-simplified version described in the article, that allow us to predict and detect rewards better in the future.

One of its most important functions is reward prediction where midbrain dopamine neurons fire when a big reward is expected even when it doesn’t occur – such as in a near-miss money-loss when gambling – a very unpleasant experience.

But what counts as a reward in Wolf’s dopamine system stereotype? Whatever makes the dopamine system fire. This is a hugely circular explanation and it doesn’t account for the huge variation in what we find rewarding and what turns us on.

This is especially important in sex because people are turned on by different things. Blondes, brunettes, men, women, transsexuals, feet, being spanked by women dressed as nuns (that list is just off the top of my head you understand).

Not all sex is rewarding to all people and people have their likes, dislikes and limits.

In other words, there is more to reward than the dopamine system and in many ways it is a slave to the rest of the brain which interprets and seeks out the things we most like. It is impossible to explain sexual motivation or sexual pathology purely or, indeed, mainly as a ‘dopamine problem’.

Wolf finishes by saying that “understanding how pornography affects the brain and wreaks havoc on male virility permits people to make better-informed choices” despite clearly not understanding how pornography could affect the brain and providing nothing but anecdotes about the effect on male sexual function.

This does not mean all porn is helpful or healthy, either to individuals or society, but we should be criticising it on established effects, not on misunderstood and poorly applied neuroscience deployed in the service of bolstering shaky conclusions about its personal impact.

If we’re going to outlaw things with a large dopamine response when consumed then sugar should be at the top of the list. Sugar consumption has a proven, direct, relationship to incidences and severity of diabetes, heart disease and dozens of other illnesses.

Is Naomi Wolf protesting the evils of sugar? No. Women are eager consumers of sugar.

Humans evolved as naked creatures and genitalia of both sexes were readily visible for the vast part of our genetic heritage. We’re supposed to see each other’s bodies. We probably evolved watching other people around us having sex. That is normal still in some cultures.

I love the blog, but I am going to have to respectfully degree with some of your conclusions on this post. Your statement suggesting unequivocally that pornography is not at all related to problems in sexuality. In a ten second search on psychinfo, I found several articles which would suggest otherwise, one of which was an actual experiment. In addition,there is likely a big difference between self-reported life enhancement and actual enhancement. With regards to “emotional closeness,” the study cited was made entirely of males and the method was entirely self-report. Making a definitive statement like that with three shaky sources seems to be every bit as shaky as Mrs. Woolf’s conclusion.

Could you post links to the studies? I found no such studies, however, the area is clearly not extensively researched. Nevertheless, the studies I linked to suggest there is no convincing evidence that porn use increases the chance of sexual dysfunction but I’d be happy to hear of other work (there are several studies that have found the reverse association – that people with sexual problems use more porn but nothing to suggest that there is a causal link).

From what I can fathom dopamine is released in the nucleus accumbens for both sex and drugs and it would seem both fall under the “hedonia” function of dopamine, whereas the future reward prediction relies on the prefrontal mesocortical pathway. I read a NY Times article that differentiated these two dopamine circuits, stating that if the limbic brain dopamine is relied on then this goes against the prefrontal dopamine circuit. Since there will be lack of the prefrontal inhibition of the dopamine limbic hedonia then an addiction develops. It may not be the same as a drug blocking the dopamine uptake, thereby causing degradation, but it still seems to be a positive feedback system.

Robert Sapolsky emphasizes that when the male has the external ejaculation it is a trigger from the parasympathetic system to the sympathetic stress system and so the male has an increase in stress hormones from external ejaculation. Dopamine is a precursor to the stress hormones. In contrast the bonobo male primates rarely ejaculate and the bonobos are a peaceful society compared to chimpanzees and humans. This would also fall into the “dopaminergic mind hypothesis” — if the limbic dopamine system takes over along with the male external ejaculation triggering the stress hormones.

First, her argument in regard to dopamine and porn is a perfect example of the post hoc fallacy, as saintneko pointed out. The entire tone of the piece smacks of a slippery slope argument. Actually, it’s more or less the same argument we’ve been hearing for decades about how marijuana in the gateway to narcotics or violent video games are the gateway to violent crime.

Also, I find it somewhat amusing that a woman is making such claims about men and porn. She gets away with it by using neurobabble. Now, this doesn’t mean I would be any less critical of the argument had it been made by a man; the gender is irrelevant to the validity of the argument, but it does make the entire thing seem that much more absurd.

I would hope no one would take me seriously were I to write an article arguing that the overabundance and ubiquity of female shoes are making women unable to inhibit their shopping impulses.

In reference to Drew’s comment – I know a brain injured person with an addiction to porn. He suffered an orbitofrontal brain injury, and didn’t have the problem before hand (according to a relative of his) so arguing cause in this case is more reasonable. Though my example is anecdotal, there are other examples of sexual disinhibition in the literature, e.g. Burn & Swerdlow (2003)http://archneur.ama-assn.org/cgi/reprint/60/3/437.pdf

Getting back to Wolf’s article – I actually think there might be something to her hypothesis. The problem is that she’s presenting a hypothesis (presumeably with anecdotal evidence which is an example of her own availability and representitiveness heuristics) but is presenting it as if it has a good scientific evidence base.

If we hypothesise that porn desensitizes men sexually, and that more porn and more unsusual porn are then required, non-neuro studies into sex addiction should be out there. So far as I know, sex addiction is quite contentious, with some clinicians and researchers considering it a genuine problem, and others not so.

To establish a neuropsychological explanation, we’d have to use something like an fMRI BOLD signal to indicate abnormal metabolism in the nucleus accumbens or orbitofrontal cortex, or some other hypothesized area. Even then, this would just be an association, not evidence of cause – it might have been that the brain abormality caused the porn addiction, and not vice versa. In fact, I would imagine that most men with a porn problem in fact have an underlaying impulse control problem, requiring immediate rewards – hence a better hypothesis might be that people with these kinds of problems have porn problems more often. For example, do men with ADHD use more porn than the general male population?

Finally, in order to establish a neuropsychological causal link, we have to either rely on things like the brain injury literature, or else devise some kind of longitudinal, experimental imaging study. If we picked 25 men to be our porn guinea pigs, and 25 as a control group, and gave the guinea pig group increasingly bizarre and deviant porn, we might then be able to use fMRI at 3, 6 and 12 months to see if the porn caused any brain changes. To my knowledge, this study has not been done, probably because of the damn ethics committee.

Since sex offenses have dropped significantly over the decade or so that porn has been available on the Internet, might it be that the desensitization isn’t causing more difficulty in controlling impulses but actually adding a layer of social protection for females who might have been targets in the past? So, by following the fear course that Wolf seems to be proposing, we might actually make life more sexually dangerous again for women? Perhaps she should think twice. Or maybe just once. (Violent criminal offending, btw, has also declined with the rise of Internet and video game availability. Just saying.)

While the dopamine reference might be inappropriate, the general idea is not impossible. It reminds me of how argument for high fructose corn syrup years ago.

As to the question of whether the brain can become pathological over stimuli rather than compounds/drugs. Saying ‘no’ to that a priori also sounds premature – a pseudo scientific taboo.

Researchers study the effect of violent video games, and social isolation and the same questions could be leveled at them. I wonder if you were to take the word porn in and put in meditation or incarceration, whether you would want to react in this way?

I am not a neuroscientist so I cannot comment on the the affects that dopamine has on the workings of the brain. However from an economic perspective, advertising works wonders at creating desire through imagery. Desire eventually leads to an increase of sales and a higher turnover of goods in the market place. Customers are generally satisfied with what they have, until a new improved model is advertised, and then suddenly the old model losses appeal and the new model with unique functions becomes a must have. Is pornography not just another form of advertising?

I’m not sure who is more guilty of misusing addiction research, Naomi Wolf or vaughanbell.

The impression one might get from the vaughanbell post is that dopamine is not involved in addiction, that desensitization is the same as habituation, that the reward circuitry is not involved in all addictions, and behavioral addictions involve different mechanisms from drug addictions. These would be false impressions.

First the author states that habituation and desensitization are synonymous. This is incorrect, yet much of his post relies on this false premise. Desensitization refers to chronic changes present in addiction process that involve a decline in dopamine signaling. One very important, and often measured, aspect of desensitization is a decline in D2 receptors.

He is correct in describing a declining dopamine response to stimuli as habituation. This is a normal response, for example with hunger. When one is hungry, dopamine rises in anticipation of taking that first bite of a burger. As lunch continues, dopamine declines and we become habituated (satiety). This normal process, which measures the salience or value of stimuli is quite different from the pathological change characterized by addiction researchers. Habituation happens thousands of times a day, desensitization occurs after chronic, usually long-term exposure.

QUOTE:’It’s important to point out that this densensitisation research is almost always on the repetition of exactly the same images. We would clearly be in trouble if any sexual experience caused us to densensitise to sex as we’d likely lose all interest by our early twenties’.

In the above quote he makes 2 points that militate against his thesis. First, he acknowledges that viewing the same images causes a loss of interest (decline in dopamine). I seriously doubt that a porn user would watch the same image throughout one session, let alone day after day. What makes Internet porn so appealing is the ability to move from one image or video to another, one genre to the next. Each new scene provides another possible spike of dopamine. Unlike drugs or food, there are no satiation mechanisms to inhibit porn viewing except orgasm, and many users forego it for hours, either because they want the dopamine buzz, or because they are having trouble climaxing due to brain changes from excess.

Second, the example of a young man becoming desensitized on sex is irrelevant (although most monogamous couples see a decline over time in sexual activity). Internet porn is not sex. As mentioned, the endless novelty that Internet porn provides allow one to seek (dopamine spike) a more exciting scene (dopamine spike), as soon as one becomes bored with the current scene (no dopamine spikes). Porn is somewhat analogous to gambling as vaughanbell described, except with the added incentive of sexual stimuli, and without the loss of money. It’s telling that the brains of pathological gamblers manifest alterations similar to those of drug addicts. Accordingly, psychiatrists are re-categorizing pathological gambling from ‘disorder’ to ‘addiction’ in the upcoming DSM-5.

QUOTE: “With regard to dopamine, it is indeed involved in sexual response, but this is not identical to the systems involved with gambling or cocaine as different rewards rely on different circuits in the brain – although doesn’t it sound great to lump those vices together?”

I believe Wolf was suggesting that all addictions involve the mesolimbic dopamine pathway. Are you, vaughnbell, saying this is not the case? Perhaps cocaine and gambling are differentiated by activation of unique subsets of neurons, yet the “reward circuitry is without a doubt involved in both the salient and hedonic aspects of all addictions. Just for the record, the theory of separate circuits within the dopamine pathways coding for separate stimuli is not a settled matter. This recent study suggests there may be considerable overlap in neurons that code for reward value:How do dopamine neurons represent positive and negative motivational events?
Masayuki Matsumoto1 and Okihide Hikosaka1
Nature. 2009 June 11; 459(7248): 837–841.

“It has generally been assumed that midbrain dopamine neurons form a unified functional group, all representing reward-related signals in a similar manner1. Our results are roughly consistent with this idea as far as the reward-related signals are concerned. However, clear heterogeneity was revealed when we examined their responses to aversive events.

QUOTE: “Furthermore, Wolf relies on a cartoon character version of the reward system where dopamine squirts are represented as the brain’s pleasurable pats on the back. But the reward is not the dopamine. Dopamine is a neurochemical used for various types of signalling, none of which match the over-simplified version described in the article, that allow us to predict and detect rewards better in the future”

It’s true that dopamine fires for potentially aversive and rewarding stimuli. In other words, for what is potentially salient or valuable. Dopamine is ‘wanting,’ whereas other neurochemicals, such as opioids are ‘liking.’ This is a straw man argument, however, as Wolf’s article was written for a lay audience, and vaughnbell’s point does not negate that dopamine dysregulation is involved with all addictions. Addictions are pathological wanting.

I was eager to read Vaughanbell’s critique in hopes of finding solid addiction neuroscience based the latest findings. However, the tone of his post caused me to check out some of his other writing. His bias on the subject of behavioral addictions is evident, and it appears to be clouding his assessment of Wolf’s hypothesis that heavy porn use may be altering users’ brains in detrimental ways. Vaughanbell has said,

“Despite the scientific implausibility of the same disease—addiction—underlying both damaging heroin use and overenthusiasm for World of Warcraft, the concept has run wild in the popular imagination. Our enthusiasm for labeling new forms of addictions seems to have arisen from a perfect storm of pop medicine, pseudo-neuroscience, and misplaced sympathy for the miserable.”

Vaughanbell uses a very misleading argument when it comes to dismissing behavioral addictions. He correctly states that the idea that “dopamine = addiction” is wrong. But this is not what behavioral addiction experts are saying. Based on brain research on overeaters, pathological gamblers and, now, fervent video gamers, these experts (and Wolf) are saying that “dopamine dysregulation (i.e., brain changes over time in response to overstimulation) = addiction.” That conclusion is, in fact, well supported by years of brain research.

If extensive overstimulation via Internet addiction can cause dopamine dysregulation in some users then it’s difficult to see how extensive overstimulation via Internet porn addiction cannot pose a similar risk. At the very least, Wolf’s hypothesis merits investigation, not derision. As an addiction-science matter, it’s most unlikely that there’s a separate brain mechanism for porn use, which magically prevents it from dysregulating dopamine in the same way as Internet addiction does, as Vaughanbell implies.

Vaughanbell correctly instructs us that dopamine does not equal pleasure. Yet he fails to make it clear to his readers that dopamine still lies at the heart of all addictions, via the mesolimbic dopamine pathway. Watching a sunset, petting a cat, and cheering on a favorite team release dopamine, but they are not the same as more intense stimulation in terms of corresponding dopamine released in the brain. For normal pleasures, we get little spikes of dopamine. Then the brain returns to homeostasis.

In contrast, via Internet stimulation users can keep substantial spikes of dopamine going indefinitely. Dopamine soars in response to “hunting,” novelty, exceeding expectations, shock and anxiety. The Internet furnishes an endless stream of stimulation with these characteristics, which can lead to tolerance (escalation). Said one young guy who had been worried about his sexual orientation due to his use of transexual porn:

“Porn binges for 4-6 hours the last couple days. On the plus side, it did become more obvious that the transexual porn is unrelated to my sexuality. After spending 30+ hours over the past 5 days watching porn, transexual porn started to become boring! I began searching for other more disgusting and shocking stuff.”

The fact that sex is good for us doesn’t prove that too much extreme sexual stimulation cannot dysregulate dopamine, or that we, as a culture, shouldn’t look more closely at the possible unintended effects of today’s Internet erotica on the brains of heavy users. “Different strokes for different folks” is a fine philosophy, but it shouldn’t extend to escalation that alters brains in fundamental ways with important implications for eroding the brain’s executive function and wellbeing of the user.

Speaking of wellbeing, Wolf also raises the possibility that today’s porn is adversely affecting male virility. Vaughanbell’s readers may want to have a look at this article about a 28,000-person survey in Italy, sponsored by an association of urologists who are seeing more and more youthful erectile dysfunction. The president of the association, Carlo Foresta, who is also a professor at the University of Padua, reports that the effects of Internet porn use on those affected are gradual, but devastating. “There is a general drop in libido and in the end it becomes impossible to get an erection.” http://www.ansa.it/web/notizie/rubriche/english/2011/02/24/visualizza_new.html_1583160579.html

Men on many English-speaking forums (for example, bodybuilder sites, medhelp sites and pick-up-artist sites. Example: http://forum.bodybuilding.com/showthread.php?t=136116941) are reporting these same problems and are sometimes desperate for solutions. The phenomenon appears to be reversible, but it takes months of avoiding overstimulation. The progression of the desensitization and recovery in youthful ED sufferers is consistent with the hypothesis that today’s porn desensitizes some brains, and that it takes time to restore them to normal dopamine responsiveness.

It would be good to know exactly what goes on in the brains of heavy porn users, and who might be vulnerable to overstimulation. We humans may be more susceptible than we think when it comes to extreme versions of natural rewards. After all, since our diet has shifted in the direction of cheap junk food crafted for maximum appeal to our dopamine-driven reward circuitry, we’ve gained a lot of weight as a society. 79% of Americans are overweight, and half of those obese (with only 10% of those for metabolic reasons according to neuroscientist and “Compass of Pleasure” author, David Linden). Frankly, we can’t even yet be confident that problematic Internet porn use would be confined to impulsives and novelty seekers, when pathological eating is not.

Vaughnbell is certainly entitled to his opinions, but they don’t appear to be consistent with the latest research on Internet addiction. That said, I’m grateful to him for continuing the debate.

@Philo Just to be fair to Vaughan, I think the main reasons why he was so critical of Wolf’s article is that she is presenting a hypothesis, but in mainstream media, as if it is fact with a good evidence base.

Now I don’t disagree with any of the studies you have cited about dopamine and internet addictions. However, these are cross sectional study designs, meaning that all they show are associations. This means its not really possible to attribute cause from these studies. Is it, as Wolf suggests, that the porn use causes the brain abnormality, or is it the brain abnormality that causes the problematic porn use? The only way we could really determine cause is to have a control group with no porn, and a test group who are given increasingly bizarre and deviant porn, over a long period of time. As I said in my earlier post, the ethics committee will probably never allow this experiment!

Imagine that it is entirely the porn use that causes the brain abnormality. Wouldn’t we then have the case where every male that has used pornography becomes an addicted user? Likewise, if this were true of alcohol, drugs such as cocaine and gambling, wouldn’t every person who had ever partaken of these vices become hopelessly addicted?

I hope my exaggerated example makes sense. Its far more likely that problematic users or addicts to drugs, gambling, pornography or world of warcraft have an underlying problem which makes them more susceptible to addiction (perhaps something like ADHD, an abnormality in the orbitofrontal cortex, or a mild brain injury from being knocked out playing sports). This would explain why some users of these things develop addiction problems, whilst many others are able to use them in a relatively healthy way.

The problem with some cognitive neuroscience as it is portrayed in the media is that it gives the impression that biological models can explain everything, whereas in fact its vitally important to consider psychological and social causes as well.

Diathesis-stress models in medicine emphasize genetic susceptibility as well as environmental stress – For example, in our case, a man with abnormal dopaminergic system who goes through a particularly harsh relationship breakup might develop a porn addiction, whereas his friends might use it without developing an addiction.

Biopsychosocial models emphasize psychological interpretations in addition to the bio and social aspects emphasized by diathesis-stress models. For example, if the man in our example also had a low self esteem, due to a cognitive evaluation that the relationship breakup was entirely his fault, he might retreat into using porn instead of meeting other women. As psychologists we’d suggest using CBT to treat this aspect of the problem (possibly some counselling as well), but note that just because we emphasize the psychological, doesn’t mean we discount the real life social and biological causes as well.

Good points. As you say, associations do not prove cause. However, they can certainly furnish reasons for caution.

Since ethics committees will not allow the necessary tests, we, as a society, will have to look elsewhere to make informed decisions about Internet pornography use. Right now, the absence of conclusive research is being touted by certain elements as “proof” that Internet porn use is harmless. In light of the associations in the existing research on behavioral addictions, this is more irresponsible than Wolf’s efforts.

As to your suggestion that abnormalities came before porn problems, I would suggest the following hypothesis: The underlying issue is dopamine dysregulation. Obviously, those with genetic makeup that leaves them with low D2 receptors in key brain areas will be more susceptible, as will those whose brain chemistry is affected by trauma. So far we’re in agreement.

But there are three basic “natural rewards”: eating, sex and bonding. Is it possible that when presented with unlimited access to extreme versions of these natural rewards a much wider swath of the population will develop addiction? This certainly seems to be the case with highly palatable food. For example, in the research mentioned below, nearly all of the animals given unlimited access to fattening foods showed a drop in D2 receptors that parallels the drop in drug users. The rats binged to obesity.

Humans seem to be very similar, with the same drop in D2 receptors (see below) and, by the way, hypofrontality. Given that we care desperately about our weight, isn’t it shocking that already 79% of adult Americans are overweight (half of those obese)? A recent study showed 9/10 college age males are using porn. Hmmm…

I’m certainly not saying that everyone who uses Internet porn will get hooked, and I agree with you that other factors are relevant. But I think it’s somewhat reckless to insist that pre-existing conditions are the whole story when it comes to addiction to extreme versions of natural reinforcers. They may be far riskier for us than drugs or alcohol in terms of percentage of population that’s vulnerable.

Another thing that makes me doubt that pre-existing conditions tell the whole story in the case of natural rewards is that so many of the men at our website bounce back in really fundamental ways when they get off of Internet porn for a couple of months. Men who have been depressive introverts since highspeed Internet became available rediscover their inner extrovert, peace of mind, and so forth. Example: “Day 64: Successful, great, normal sex” http://marnia.scienceblog.com/36/day-64-successful-great-normal-sex/ Please note that in the research below, the D2 receptors of obese patients who stopped overeating rose significantly. I suspect similar things are happening in recovering porn users.

At the same time, there are others who clearly have the conditions you mention. They improve when they leave porn behind, but they still need the kinds of therapy you recommend to break through other issues. Ideally, psychologists will support both aspects of recovery, but most have been trained to encourage clients to masturbate ad libitum, with no awareness of the possible consequences. Today’s youngsters consider masturbation and Internet porn synonymous. Many can’t conceive that masturbation is even possible without the Internet, having never done it any other way.

Sorry for the delay in replying, for some reason I didn’t get emailed when you replied (I think we need to tick the notify box after each comment, rather than just once per blog post)

The issue of proof is important here, as is the issue of exactly what is meant by addiction. Generally speaking, in order for something to be considered an addiction, it needs to be harmful, and needs to be displacing other activities. The misuse of the word addiction in the media, to refer to any activity which people like to engage in a lot of the time, is perhaps what Vaughan was so riled about. No doubt there are men with porn addictions, but the implication from Wolf’s original article is that this is the norm, rather than the exception.

On the issue of proof, the problem is that its not possible to prove a negative. It may be possible to prove a causal link between porn use and brain changes causing desensitivity, but its not possible to prove that porn doesn’t do this. All that we can have is studies which support the null hypothesis, and a lack of studies to support the hypothesis. Of course, then people who disagree can say “an absence of evidence is not evidence of absence.” Thats one reason why its difficult to refute these kinds of ideas.

I read the post on your blog, and I do accept that some men have problems with porn, although with two caveats. Firstly, I still feel that its unlikely that porn is the primary cause of these problems, otherwise I think its very likely that about 90% of the male population would suffer from this addiction. Instead I think that problems such as depression, low self esteem and ADHD might cause problems with porn use, which then prevent the person from recovering in terms of healthy relationships with women. Secondly, I do think that as you are running a website about this topic, you might be encountering what we call a selection bias, in that you are in contact with men who do have a problem with this, and are not in contact with a probably much larger group of men who use porn but don’t have a problem with it.

Anyway, thanks for an interesting discussion – I’m hoping to train as and then work as a clinical psychologist when I finish my PhD, and these sorts of issues are rarely talked about.

I think a possible problem with porn is that it forms a highly unrepresentative sample of human sexuality and physiology.

If our self-concept and ideas about what’s “normal” are influenced by example, then it seems extraordinary if frequent porn use did not skew an individual’s perspective on reality, possibly in quite negative ways.

Is Naomi Wolf promoting another book of hers? What she is basically saying (re: porno images losing their power) is that habituation occurs. Um, is this new? I think not.
Is it possible for people, not just men (which is why I find Naomi’s thesis absurd), to be habituated to porn? Yes. It’s like anything else isn’t it? Have too much, at frequently intervals and it loses its appeal. Does it mean that it rewires the brain? No.
I wish feminists like Wolf would actually bother to research things before they sprout of absurd hypotheses.

To A.K.
Naomi Wolf did not use the term habituation, she used the term desensitization. As explained in my above post, the terms have two quite different definitions. Habituation is occurs when (your example) are viewing images, maybe your friends vacation to Yellowstone, and you are ready to move click on the next picture in a few seconds. Desensitization is an addiction term refers to a downregulation of D2 dopamine receptors and a decrease of baseline dopamine. It’s a hallmark of all addictions. The author of this post purposely misleads the reader by suggesting these two terms are interchangeable. One is caused by addiction processes, the other is a moment to moment normal process.

Nothing absurd as addictions to natural rewards such as food, gambling, and video gaming have demonstrated desensitization of the reward circuitry. Two of the top researchers in the addiction field disagree with you:

The head of the National Institute on Drug Abuse (NIDA) Doctor Nora Volkow, has suggested the agency’s name be changed to the “National Institute for Diseases of Addiction,”, to address behavioral addictions such as pathological gambling, overeating and compulsive pornography usehttp://www.sciencemag.org/content/317/5834/23.1.citation

Another prominent addiction researcher, Eric Nestler, has this Q & A on his websiteQUESTION: Do these changes occur naturally in your brain without the influence of a drug of abuse?
ANSWER: “It is likely that similar brain changes occur in other pathological conditions which involve the excessive consumption of natural rewards, conditions such as pathological over-eating, pathological gambling, sex addictions, and so on.”http://neuroscience.mssm.edu/NeuroscienceLabs/NestlerLab/faq.php

As stated, behavioral addictions and drug adictions involve the same basic mechanisms(sensitization, desensitization, and reduced frontal cortex activity), and the same pathways (the mesolimbic dopamine pathway).

@Glarion –
Desensitization does have different meanings, depending on the context in which it is used. To the lay reader of either Vaughan’s or Wolf’s articles, I think most people would consider it in terms of psychological desensitization, rather than receptor downregulation.

Strangely, the use of desensitization does peak in the 1970’s, which makes Vaughan’s Google scholar results look less odd. I think its highly likely that most readers in English will be using it in a purely psychological sense, and not a neuropsychopharmacological sense. We can only guess at which use Naomi Wolf meant, (unless you secretly are Naomi Wolf ?🙂

I read Wolf’s ‘Promiscuities’ when I was still in school and it had a massive and positive influence on me, setting me on the path to be the pleasure-loving deviant I am today. I also love the scientific method, though! And it really upsets me that Wolf nowadays talks so much crap. Anyhow, thanks for the interesting post🙂

No one knows the percentage of Internet porn users who would answer ‘yes’ to at least three. There’s good reason to believe it’s greater than when “Playboy” reigned, given the scope of distress reported on the Web. In this review, Dr. Nora Volkow, Head of NIDA, explains the three key, measurable addiction characteristics: Sensitization, desensitization, and hypofrontality. (Please see her comment on addiction in another post here – she believes some users are meeting the parameters of porn addiction.)

These three key changes occur in pathological gamblers, those with Internet/gaming addiction, and in the obese. Vaughn misled readers, as addiction researchers are not in disagreement that natural rewards can cause brain changes that mimic those found in drug addicts.

I agree with you that pre-existing conditions play a major factor in most addictions. However, this model is insufficient to explain addiction to supernormal versions of natural rewards, such as junk food and Internet porn. Are you suggesting that the 35% of adult Americans who are obese suffer a pre-existing condition? Either they do, or your model is invalid for natural rewards.

We hear from many guys addicted to porn who have no other addiction, or pre-existing condition. For many, the porn-induced symptoms (ADHD, anxiety, lethargy, hyperactivity, depression, etc) they feared ‘magically’ disappear as they leave Internet porn behind. Others do have pre-existing conditions, which remain and need to be addressed.

A significant portion of the population find potentially addictive drugs aversive, or the aftereffects unpleasant. According to Volkow, those who don’t find methamphetamine aversive tend to have low D2 receptors, and may be only 10-15% of the population. On the other hand, there is not a heterosexual teen alive who dislikes looking at pretty girls.

It’s true that our newest site is for porn users. However, our other site, which has been up for 10 years, didn’t even contain the word ‘porn’ when users started showing up. Men dealing with porn issues found us through a Google fluke and proceeded to post on our forum. We hoped they would go away, but they stayed.

Over the last 8 months that the porn-related site has been in operation, hundreds of forums in 20 different countries have linked to it. Only ten were porn recovery forums. The other sites ranged from bodybuilding, diet, pickup artist, gaming, medical, sports, to autos, and basically anywhere men congregate. Having read thousands of threads, with sometimes hundreds of posts, I can tell you this is a very widespread problem affecting a diverse population. It’s naïve to assume that substance-addiction percentages/pre-existing conditions automatically describe addiction to natural rewards.

I suspect we are seeing only the first waves of men affected, as severe desensitization can require years of highspeed Internet access. Meanwhile, men have naturally conflated the advice that “masturbation is healthy” with “Internet porn use is healthy,” oblivious to the very different potential effects on the brain’s delicate reward circuitry.

The way porn is delivered today is totally unlike viewing a monthly “Playboy,” or driving to the adult store for a rental. Contrary to Vaughn’s spin job about habituation, the Internet makes possible a never-ending stream of dopamine spikes. Today’s users can force dopamine’s release by watching porn in multiple windows, searching endlessly, fast-forwarding to the bits they find hottest, switching to live sex chat, viewing constant novelty, firing up their mirror neurons with video action and cam-2-cam, or escalating to extreme genres and anxiety-producing material. It’s all free, easy to access, available within seconds, 24 hours a day, 7 days a week.

It’s easy to claim that Wolf should have waited for controlled studies of the type we’d all like to see before warning users of telltale findings with regard to other behavioral addictions. But as Internet porn use is ubiquitous, and access easier by the day, it pays to consider all available evidence, even before the ideal evidence is obtained (if ever).

As one researcher pointed out (about another phenomenon), randomized, controlled trials have never been the sole arbiter of medical thinking or policy. If they were, we would all still be smoking cigarettes and no one would be wearing seat belts. Nobody was randomly assigned to such hazards. Rather, a flood of other evidence established their risk and benefit.

Think about it. What addiction has ever been established by risking creating addicts? Why should Internet porn use be the exception? Why ignore the mounting anecdotal evidence of addiction – especially in light of our scientific understanding of other behavioral addictions? This is reckless thinking, born of prejudice or, perhaps, pervasive propaganda.

Instead of wringing our hands as a society, and saying we can’t prove a null so we shouldn’t talk about what’s actually happening until we have studies that cannot be conducted, why not scan the brains of recovering porn users and see if their dopamine receptors return to normal, as has been done with formerly obese people, and other addicts?

@Philo – I was kind of joking about the randomized control trial – Of course you’d never get ethical approval to conduct one.

The problem is this, as you say, we currently have no idea how many men have a problem with porn addiction, and we currently have no data on how heavy porn use affects men’s brains. We have data on how cocaine use affects addicts brains, and we know that sexual stimuli affects some of the same dopaminergic pathways (as well as other brain areas, as Vaughan points out) but we do not have equivalent data for porn use.

This is the problem with Wolf’s article – she states a reasonable hypothesis, but presents it as if it has good empirical data supporting it, and then talks about findings from cocaine addiction studies as if they apply to studies on sex and/or porn use.

I still think more studies are required. Whilst I do not dispute that you are encountering porn addicted men at your website, I think you you almost certainly have a selection bias, and that there may well be a much larger proportion of men who use porn without addiction.

As an example, its fairly well established now that cannabis use can increase the chances of developing schizophrenia between 40 to 100%. Less reported is that this increases an individual’s chances from approximately 1% to 1.4% (or 2% depending on which study you read). Now imagine that you are a psychiatrist who treats schizophrenics. If the 2% study is correct, then its likely that a massive 50% of your schizophrenic patients are cannabis users! Assuming most psychiatrists are not cannabis users themselves (and also were not when they were students) this means that their availability heuristic (worldview of cannabis) is that it is a major cause of schizophrenia, and is incredibly dangerous. Of course, this ignores the fact that 99% of the normal population don’t have schizophrenia, and that 98% of the cannabis using population don’t have schizophrenia.

I hope you can see that my rather extreme example is also relevant to porn use. Whilst I agree with you that some men have addiction problems, I feel that the size of this proportion is unknown. However, I feel that parallels can also be drawn with alcohol use, which is an enjoyable activity for most people, but a dangerous and life destroying addiction for a minority.
study, as recruiting from a porn addi

To Tom: Desensitization. It’s sad that you would employ the same tactic as the OP: First, ignoring Wolf’s use of the word and substituting a definition which has no relevance to her article, dopamine, or desensitization of the mesolimbic dopamine system. And then attempting to discredit her hypothesis with evidence related to an irrelevant definition.

In Wolf’s article, dopamine is used six times. She describes desensitization of the reward circuitry several times. Vaughn linked to studies that had nothing to do with dopamine or desensitization as used in Wolf’s article. Your link is equally irrelevant. Talk about misuse of science – citing abstracts that have no mention of dopamine is serious misuse.

One of two possibilities exists:
1) You are choosing to purposely mislead readers, or
2)You don’t understand addiction neuroscience.

@Tom Sorry your message got cut off, but I think I see the points you’re trying to make. First the absence of brain scans of heavy porn users is unfortunate, but it makes no sense to ignore the mountain of evidence for other behavioral addictions. Of course more studies are needed, but as with smoking in the early days, people can consider the evidence already available and make intelligent decisions – or they could if people like Vaughnbell weren’t deliberately discouraging them from doing so.

Actually, I don’t see the relevance of your example. Of course statistics can be made to “lie.” The key point is that our reward circuit evolved to respond to highly palatable foods and sexual stimulation, not the chemicals in pot. Perhaps only people with pre-existing conditions get hooked on pot, but that tells us nothing about the risks of junk food or today’s Internet porn use.

You haven’t answered the burning question: Do you believe that the 35% of Americans who are obese have a pre-existing condition? Either they do, or else supernormal versions of natural rewards are fundamentally different from addictive chemicals in terms of risk of addiction. Hint: Hunter-gatherers rarely got fat, let alone obese, which means food addiction was almost unheard of.

Sex addiction is probably quite rare, and likely nonexistent in hunter-gatherers. However, Internet porn use is not sex. Sex addiction is human-to-human interaction; Internet porn is screen-to-human. The vast majority of men who arrive at our two sites would never become “sex addicts.” For them it’s Internet porn, and nothing else. As described, the privacy, ease, and delivery method of Internet pornography creates a completely different animal in terms of addictiveness. This is affirmed by the fact that many young healthy men are experiencing porn-induced ED. I’ve not heard of sex or masturbation causing chronic ED.

Musician John Mayer: “Pornography? It’s a new synaptic pathway. You wake up in the morning, open a thumbnail page, and it leads to a Pandora’s box of visuals. There have probably been days when I saw 300 vaginas before I got out of bed.”

It’s unlikely a hunter-gatherer would have seen 300 women in his lifetime. What magazine or rental could come close to the dopamine-elevating novelty the Internet provides? Psychologists seem stuck in 1956, fighting a battle against Victorian morals. There’s no more battle. The average age for starting Internet porn is eleven, just when the brain experiences an explosion of growth, and is especially sensitive to dopamine signals – and before the pre-frontal cortex (executive function) has fully developed. And you’re confident that porn addiction is a tiny little problem confined to a few unlucky souls with pre-existing conditions. Honestly, that strikes me as far more unscientific than Wolf’s hypothesis.

I think your obesity example is good. Why is it that 35% of American’s are obese and that the US has the highest rates of obesity? (we in the UK are not far behind, with the second highest rates).

It can’t be simply food, after all, every human being eats, so it must be particular foods eaten in the 1st world economies right? But then surely all people in those countries would be obese? So perhaps its genetic and food related? The thrifty gene hypothesis is put forward to explain higher rates of obesity and diabetes in native americans compared to non native americans:http://en.wikipedia.org/wiki/Thrifty_gene_hypothesis

But of course, personal choice and habits are important too, which is why I feel that diathesis stress and biopsychosocial models of illness are much better at explaining all illnesses (including addiction) than environmental models (i.e. its just the food, or its just the porn).

I think we agree that more research is required. If you were to approach a neuroscientist involved in addiction brain imaging studies and supply him with participants (men with a porn problem) whom the neuroscientists could compare to a control group (porn using men without a problem, and perhaps non porn using men as well) then we’d have some hard data to discuss. We psychologists could survey a much larger group of men to determine what proportion actually have a porn addiction, and what proportion use porn without a problem. It might be that the proportion is larger than I think, but perhaps smaller than you think.

Either way, if just 1% of men have an addiction problem with porn, that is a very large number of men, and a health issue that is not very studied in psychology. Maybe I can do some research in this area when I finish my PhD.

I need to get on with writing my thesis now, so I won’t reply again, but thanks for the conversation.

@Glarion – Fine – here are Naomi Wolf’s uses of the word desensitization – you can decide for yourself if she is talking about downregulation or receptor desensitization, but I think its quite clear that she’s using it in the much more widely used psychological sense, meaning to make less sensitive towards.

“The hypothesis among the experts [therapists and counsellors – NOT neuroscientists] was that pornography was progressively desensitizing these men sexually.”

To be fair, she says its a hypothesis here – thats good science journalism by her.

“Indeed, hardcore pornography’s effectiveness in achieving rapid desensitization in subjects has led to its frequent use in training doctors and military teams to deal with very shocking or sensitive situations.

Given the desensitization effect on most male subjects, researchers found that they quickly required higher levels of stimulation to achieve the same level of arousal. The experts I interviewed at the time were speculating that porn use was desensitizing healthy young men to the erotic appeal of their own partners.”

All of this is mentioned BEFORE any mention of the dopaminergic system.

Now look, she may be correct – its a reasonable hypothesis, but the problem is that she’s stating this as if there is direct evidence about porn use, addiction and the dopamine system – There is not, she is implying all of this evidence from the cocaine literature and the fact that mesolimbic and nucleus accumbens dopamine are involved in all reward expectation type stimuli.

The problem here isn’t really a scientific one in my opinion. If an fMRI or PET study came out showing decreased dopamine metabolism, or other biomarkers indicative of addiction in heavy porn users, and this was combined with larger psychological surveys indicating what proportion of men have a porn addiction problem (I hypothesize that its quite a small proportion) then psychologists like Vaughan and I will accept that, as scientists.

Thats the point of science – making a hypothesis and looking for data. To report hypotheses as if they have directly relevant data supporting them as Naomi Wolf has done seems to be to be pushing a extreme feminist agenda (rather than the balanced feminist agenda of equality, to which I subscribe whole heartedly). Finally, suggesting that porn is dangerously addictive, Wolf is implying that it belongs in the category of addictive drugs. The war on drugs in the US is retarded.

I won’t debate the politics of motivation here, as this is not a forum for that, and I should really be writing up my PhD.

Now you are spinning. She mentions dopamine six times, but since it’s placed after the necessary context, she must be using an outdated definition of desensitization. You are seriously suggesting Wolf happened upon the 1963 abstract in vaughanbell’s link? His dated citations have nothing to do with addiction, and were written long before dopamine’s role in behavior, motivation or addiction was understood. As anyone can see from this quote she is talking about addiction and tolerance:The addictive potential is also identical: just as gamblers and cocaine users can become compulsive, needing to gamble or snort more and more to get the same dopamine boost, so can men consuming pornography become hooked”

I think it’s vital to keep politics and moralizing out of the porn debate. This goes for both sides of the argument. Personally, I do not advocate a war on drugs, or banning porn. Education and an honest debate will suffice for me. Vaughanbell’s piece strikes me as quite political.

I agree that brain scans, and more data are needed. However I know vaugahanbell purposely mislead the reader, which indicates a bias, which is not how science should proceed. By misrepresenting Wolf’s clear use from desensitization (long term addictive process) to habituation (moment to moment normal process), he purposely misleads the reader on points.

Wolf’s 900 word article wasn’t an academic review of all the know functions of dopamine. His focus on her omitting that dopamine is not the final reward is a sneaky tactic to imply what she did present was incorrect. It’s as if she was saying “cars need gasoline to run”, and vaughanbell’s reply was “Clearly incorrect, as she didn’t mention the fuel pump”.

Please watch this excellent video on dopamine by the head of NIDA, Nora Volkow. She mentions reward several times and does not talk about dopamine not being the final reward. Maybe vaughanbell should give her a neurobiology lesson. She correctly describes habituation (which is not desensitization).http://bigthink.com/ideas/17404 If Vaughanbell is going to hold himself out as an expert critic, he needs to be up to date on the science of the reward circuit.

To obfuscate further, Vaughanbell says that gambling, cocaine, and porn use rely on different circuits. I say they all employ the mesolimbic dopamine pathway. Does he disagree? Does he care to name the separate circuits for each of these activities?A Review of Addiction– http://www.postgradmed.org/doi/10.3810/pgm.2008.07.1802

Vaughanbell’s critique of Wolf’s neuroscience rests largely on points that can be reduced to spin. He:
1)Misuses the term ‘desensitization.’

2)Incorrectly states that additions involve different circuits. In fact, all involve dopamine and changes in the mesolimbic dopamine pathway (reward circuitry).

3)Discredits Wolf because she doesn’t discuss the fine points of experiments that are not vital to the points she made: separating ‘wanting’ from the hedonic (liking) aspects of reward functions.

I’m going to lower the tone of this wonderful discussion with a tactless interjection.

Feminists have been trying to ban porn for a long time now, and, like most things that third-wave loonie-fringe feminists do or say, it’s absurd and reeks of sanctimony.

Porn almost certainly gives would-be rapists an outlet to blast out their repressed loser-sperm. Feminists got this one wrong, and the real reason they rail against porn is that the beautiful lassies in porn are monumentally sexier than these slovenly fascist-hearted bitter feminists. Veins of rage throb on their foreheads at the thought that men have the option of masturbating to an endless stream of stunningly beautiful women instead of being shacked to the sexual access whims of one of them.

I am suspicious of any article, peson, post, study, or anything else that even left-handedly supports the toleration (much less the use) of porn. In any form or method of use, porn is porn is porn is brain poison.
My main concern is that those with the greater “educational” level seems to understand this the least.
Good job modern educational system!!!!!!!!!!

Most first-world people desperately want *not* to be overweight, and try their hardest to avoid it. The fact that 79% of Americans are overweight indicates that most people *are* vulnerable to today’s extremely palatable goodies.

In contrast, most Internet porn users are being encouraged to think that their behavior is neutral or even healthy. Given that today’s sexual online goodies are also extreme versions of natural reinforcers, it’s reckless to assume that only a few percent are at risk just because we’ve been telling ourselves there’s no such thing as “too much” for decades. This advice is likely to be wrong for our species: http://marnia.scienceblog.com/48/is-today%E2%80%99s-ejaculation-advice-right-for-our-species/

All the best with your thesis. It has been most disheartening to realize how great is the blind spot in your future profession at the moment. I’m encouraged that you’re willing to consider doing some research. It’s needed.

Vaughanbell claims that addictions involve separate pathways – “different rewards rely on different circuits in the brain”
Such a claim would suggest humans evolved individual pathways for non-essential chemicals, which is highly unlikely. He has yet to name these different pathways. The following study, which arrived a few days ago, states that addictive substance and natural rewards share the same pathways.

“A team of Duke University Medical Center and Australian scientists has found that addictive drugs may have hijacked the same nerve cells and connections in the brain that serve a powerful, ancient instinct: the appetite for salt.”

“The scientists found that the gene patterns activated by stimulating an instinctive behavior, salt appetite, were the same groups of genes regulated by cocaine or opiate (such as heroin) addiction.”

“Once the genetic program is operating, experiences that are part of the execution of the program become embodied in the overall patterns of an individual’s behavior, and some scientists have theorized that drug addiction may use nerve pathways of instinct. In this study, we have demonstrated that one classic instinct, the hunger for salt, is providing neural organization that subserves addiction to opiates and cocaine.”

Glarion, you keep repeating this claim, but you are ignoring this reference, that Vaughan cited in support of his initial comment that different rewards involve different parts of the brain:http://www.springerlink.com/content/n6134g3521036887/
“Multiple brain regions, multiple receptors, multiple distinct neurons, multiple transmitters, multiple transporters, circuits, peptides, proteins, metabolism of transmitters, and phosphorylation”

Sure, most rewards involve dopamine in some form, but to equate porn with cocaine studies is incredibly simplistic, and misleads the lay reader.

Just for the record, a very important aspect of sexual behaviour are cognitive evaluations, which depend upon various prefrontal cortex areas, involved in theory of mind, empathy, and inhibition in anticipation of negative future consequences. I know this because my PhD has a focus on neurobehavioural disability as a consequence of frontal lobe brain injury, which can include amongst other things, innapropriate sexual behaviours. Its simply not the case that porn causes all men to become addicts.

Even though this is very likely true of a minority (as I have discussed with Philo) there are many other aspects of neuropsychology and the social environment in which porn is used which are completely unconsidered by Wolf’s initial article. Hence I’m quite happy with Vaughan’s brief rebuttal of her article as a poor scientific argument.

Quoting from an abstract, without understanding its meaning, is not the best way to make an argument. Care to expand on what this study is really saying? Here’s a hint: It’s NOT saying addictions occur without dopamine or the reward circuitry.

I keep repeating what is agreed upon addiction research – that the reward circuitry is involved with all addictions. Here’s a link to a picture for the reward circuitry, which goes by several names, depending on the level of details illustrated. Here the reward circuitry is referred to as medial forebrain bundle (MFB), which includes the mesolimbic dopamine pathway.http://thebrain.mcgill.ca/flash/i/i_03/i_03_cr/i_03_cr_que/i_03_cr_que.html

Please provide evidence of one addiction that does not involve the reward circuitry. It is this reward circuitry Naomi Wolf referred to when she said “reward system.” She was talking about similarities here when she compared cocaine and gambling with porn. You are once again misleading the reader by suggesting she is being simplistic because, however unlikely it seems to the lay reader, ALL addictions involve similar alterations in the reward circuitry and similar mechanisms. (Of course there are experiential differences depending upon the nature of stimulus, additional brain regions, and subpopulations of neurons activated within reward circuit)

You may be satisfied that certain addictions do not involve the reward circuitry, but the salt study above, and addiction researchers disagree. A few examples:
—————-
One of the top addiction researchers in the world, Eric Nestler, has this Q & A on his websiteQUESTION: Do these changes occur naturally in your brain without the influence of a drug of abuse?

—————————-Food Addiction, Substance Dependence Share Common Ground. (Neural Correlates of Food Addiction – Arch Gen Psychiatry. Published online April 4, 2011) “We already know what the imaging profile is for addictive behavior and what the profile is for the reward system, which is the dopamine system. What they’re really saying is that this is a nonspecific activation pattern that is not stimulus sensitive. No matter what the addiction, it’s going to affect the same areas.”
————————————-ΔFosB Regulates Wheel Running The Journal of Neuroscience, September 2002
The finding that drug reward and a natural reward induce the same molecular adaptation (induction of ΔFosB) within the same neuronal cell type suggests that the two may act via some common mechanism.
—————————–

Imaging of Brain Dopamine Pathways- Implications for Understanding Obesity, Nora D. Volkow, MD
Behavioral studies show similarities among certain patterns of overeating and other excessive behaviors such as drinking too much alcohol and compulsive gambling. These behaviors activate brain circuitry that involves reward, motivation, decision-making, learning, and memory. In certain conditions (ie, intermittent, excessive sugar intake), rats can display behavioral and neurochemical changes that resemble those observed in animal models of drug dependence. From an evolutionary perspective, animals would benefit from a neural mechanism (circuitry) that supports an animal’s ability to pursue natural rewards (food, water, sex). These circuits, however, are sometimes dysfunctional leading to various types of disorders
—————————————The Neurobiology of Substance and Behavioral Addictions, CNS Spectr. 2006;11(12)924-930Biochemical, functional neuroimaging, genetic studies, and treatment research have suggested a strong neurobiological link between behavioral addictions and substance use disorders
————————————
You also said, “Its simply not the case that porn causes all men to become addicts.” Not sure where you got this idea. It’s not in anything I’ve said. Not everyone becomes obese, but far more do than become substance abusers.

By the way, notice what you said “most rewards involve dopamine”. Don’t let vaughanbell see that. He’ll take you to task, as he did Naomi Wolf, for equating dopamine to reward.

I just want to point out that “Philo” and “Glarion” are none other than Marina Robinson and Gary Wilson or Yourbrainonporn.com and Reuniting.info. One or both of them seems to like to drop in whenever there’s a strong refutation of simplistic claims concerning the “brain science” around pornography in order to present an ostensibly scientific counter-refutation.

And while their knowledge of neuroscience does seem impressive, there is quite a bit that sets off alarm bells. Why are they so quick to defend grossly distorted presentations of neuroscience, such as those made by Naomi Wolf? Why do they never turn up to correct the grossly simplistic, and often pseudoscientific, claims made about the roles of dopamine and oxytocin? In their counterarguments, are they presenting a full picture of the current research, or are they simply cherry-picking from research that favors their views?

Furthermore, if one looks at Reuniting.info, one is immediately struck by the overwhelming “New Age” and “Tantric” ideas about sex on this site. Are these two really about defending a scientific point of view around sex? They strike me as the equivalent of “creation scientists”, notably Michael Behe and his rhetoric about the bacterial flagellum. Like many who are highly knowledgeable about a very specific area of science, they know claims made based on that specific knowledge are not easily refuted by non-specialists, and hence use that as a wedge to make larger unfounded claims about the larger state of scientific knowledge.

I will also note that Robinson and Wilson seem to be very strongly invested in promoting a wide application of the addiction model to a wide range of compulsive or simply pleasurable behaviors, as well as a “relational” view of sexuality. I highly doubt these views have been arrived at via dispassionate scientific inquiry, and one has to wonder just how much they are bending the science to fit these views.

(Moderator – I think I posted this twice, the first time with improper formatting. Could you remove the first one?)

Considering that you avoid substantive debate, and steadfastly cling to a disproven paradigm that “behavioral addictions do not exist,” I’m not sure how to label your understanding of addiction neuroscience. In any case, this week’s news puts an end to this “debate.”

ASAM clearly states that:
1) Both behavioral and chemical addictions involve similar brain changes
2) These changes occur in the same circuitry – the reward circuitry
3) Dopamine, with its “little pats on the back,” is central to all of these brain changes

When reading the ASAM definition, please note that:
1) Like Wolf (in her 800-word-limit article), ASAM’s eight-page document did not delineate the numerous unrelated functions dopamine.
2) Like Wolf, ASAM used the term “reward.”
3) Like Wolf, ASAM clearly states that all addictions lead to the same alterations in the same neurocircuitry – the reward circuitry
4) Like Wolf, ASAM states that sex addiction exists.

———————————–

Quote from the lay article making it clear that behavioral addictions exist (sounds more like Wolf than you):The new definition leaves no doubt that all addictions—whether to alcohol, heroin or sex, say—are fundamentally the same. Dr. Raju Haleja, former president of the Canadian Society for Addiction Medicine and the chair of the ASAM committee that crafted the new definition, told The Fix, “We are looking at addiction as one disease, as opposed to those who see them as separate diseases. Addiction is addiction. It doesn’t matter what cranks your brain in that direction, once it has changed direction, you’re vulnerable to all addiction.” That the society has stamped a diagnosis of sex or gambling or food addiction as every bit as medically valid as addiction to alcohol or heroin or crystal meth may spark more controversy than its subtler but equally far-reaching assertions.
—————————————

Here ASAM states that addiction is all about what happens in the brain. The source of the addictive brain alterations is irrelevant. All current research (my links above) points to the same brain alterations: hypofrontality, desensitization, and sensitization, occurring within the reward circuitry.

1. QUESTION: What’s different about this new definition?

ANSWER:
The focus in the past has been generally on substances associated with addiction, such as alcohol, heroin, marijuana, or cocaine. This new definition makes clear that addiction is not about drugs, it’s about brains. It is not the substances a person uses that make them an addict; it is not even the quantity or frequency of use. Addiction is about what happens in a person’s brain when they are exposed to rewarding substances or rewarding behaviors, and it is more about reward circuitry in the brain and related brain structures than it is about the external chemicals or behavior that “turn on” that reward circuitry. We have recognized the role of memory, motivation and related circuitry in the manifestation and progression of this disease.
——————————————-

ASAM says (as did Wolf) that this very same neural circuitry, the reward circuitry (MFB), is involved with all addictions. From the new ASAM definition:

”Most clinicians have learned of reward pathways including projections from the ventral tegmental area (VTA) of the brain, through the median forebrain bundle (MFB), and terminating in the nucleus accumbens (Nuc Acc), in which dopamine neurons are prominent. Current neuroscience recognizes that the neurocircuitry of reward also involves a rich bi-directional circuitry connecting the nucleus accumbens and the basal forebrain. It is the reward circuitry where reward is registered, and where the most fundamental rewards such as food, hydration, sex, and nurturing exert a strong and life-sustaining influence. Alcohol, nicotine, other drugs and pathological gambling behaviors exert their initial effects by acting on the same reward circuitry that appears in the brain to make food and sex, for example, profoundly reinforcing.”
—————————————-

In these two FAQs, ASAM parallels Naomi Wolf’s description of addiction and the pesky reward circuitry that is altered by ALL addictions. It clearly states that behavioral addictions, including sex, cause addictive brain changes.

5. QUESTION: This new definition of addiction refers to addiction involving gambling, food, and sexual behaviors. Does ASAM really believe that food and sex are addicting? ANSWER: “Addiction to gambling has been well described in the scientific literature for several decades. In fact, the latest edition of the DSM (DSM-V) will list gambling disorder in the same section with substance use disorders.
The new ASAM definition makes a departure from equating addiction with just substance dependence, by describing how addiction is also related to behaviors that are rewarding. This the first time that ASAM has taken an official position that addiction is not solely “substance dependence.”
This definition says that addiction is about functioning and brain circuitry and how the structure and function of the brains of persons with addiction differ from the structure and function of the brains of persons who do not have addiction. It talks about reward circuitry in the brain and related circuitry, but the emphasis is not on the external rewards that act on the reward system. Food and sexual behaviors and gambling behaviors can be associated with the “pathological pursuit of rewards” described in this new definition of addiction.”

2. QUESTION: How is this definition of addiction different from previous descriptions such as DSM?

ANSWER: The ASAM definition of addiction does not exclude the role of environmental factors in addiction – things such as neighborhood or culture or the amount of psychological stress that a person has experienced. But it definitely looks at the role of the brain in the etiology of addiction – what is happening with brain functioning and specific brain circuitry that can explain the outward behaviors seen in addiction.
————————————-

I believe that porn addiction is more common than sex addiction and closely parallels the growth of the Internet. Here ASAM addresses sex addiction:

6. QUESTION: Who has food addiction or sex addiction? How many people is this? How do you know?

ANSWER:“We all have the brain reward circuitry that makes food and sex rewarding. In fact, this is a survival mechanism. In a healthy brain, these rewards have feedback mechanisms for satiety or ‘enough.’ In someone with addiction, the circuitry becomes dysfunctional such that the message to the individual becomes ‘more’, which leads to the pathological pursuit of rewards and/or relief through the use of substances and behaviors. So, anyone who has addiction is vulnerable to food and sex addiction. We do not have accurate figures for how many people are affected by food addiction or sex addiction, specifically. We believe it would be important to focus research on gathering this information by recognizing these aspects of addiction, which may be present with or without substance-related problems.
—————————————–

In this FAQ, and throughout its policy statement, ASAM emphasizes that all addictions share common underlying brain processes.8. QUESTION: What are implications for treatment, for funding, for policy, for ASAM?

ANSWER:“The major implication for treatment is that we cannot keep the focus just on the substances. It is important to focus on the underlying disease process in the brain that has biological, psychological, social and spiritual manifestations.

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Maybe it’s time for you to do a new post based on current, conclusive research, even if it upsets iamcuriousblue.

I’m glad you have been perusing our websites. Maybe you will learn something. First, we don’t hide who we are, as several of our above-posted links lead to our articles. In fact, we posted the debate on yourbrainonporn.com, identifying who we are – http://yourbrainonporn.com/naomi-wolf-porn-debate-2011

We chose to use nicknames here to avoid ad hominem attacks (like yours, and now Vaughan Bell’s). Such remarks assert a lot, but fail to take on the specifics. I’ve read your post several times, and cannot identify one substantive argument. My alarm bells go off when I see a post filled emotion-driven buzzwords, such as “grossly distorted”, “pseudoscientific”, “creation scientists,” “strongly invested”, “ostensibly scientific,” “claims”, etc.

We covered the relevant scientific substance, in detail, in our above posts. Care to dispute substance instead of engaging in empty rhetoric?

QUOTE: Iamcuriousblue: “Like many who are highly knowledgeable about a very specific area of science, they know claims made based on that specific knowledge are not easily refuted by non-specialists”
Really? We came here to exchange ideas with an expert on his own blog. Please note that Vaughanbell’s only substantive response was to cite a 1963 study (before the role of dopamine in addiction was elucidated) discussing an irrelevant definition of *psychological* desensitization.

The other expert, Tom, only responded with a to cite to Heterogeneity of Reward Mechanisms,, which Vaughanbell relied on to mislead Wolf’s readers. It does not say what he would have you think it does. I have the entire study and have read it. Vaughanbell cites it as evidence that not all addictions involve the reward circuitry. All addictions do, and this study actually affirmed this.
The study also explained that all addictions cause dopamine dysregulation and desensitization of the reward circuitry. “Heterogeneity” refers to the mechanisms that each drug or natural reward employ to cause dopamine deregulation within the reward circuitry. For example: Cocaine increases dopamine directly; heroin increases dopamine by reducing reward circuitry GABA; nicotine increases dopamine by increasing glutamate. Nowhere in this study does it say the reward circuitry is *not* involved, or that dopamine is not central to all addictions.
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Before you consider engaging in a substantive debate, you may want to educate yourself on the latest research on behavioral addictions. As noted and cited, all researchers who study the neurobiology of addiction agree that *all* addictions involve the same neural pathways and similar mechanisms.

I suggest starting with this 7-minute segment (“The Unyielding Power of Dopamine”) of a longer video presentation by the head of NIDA, Nora Volkow MD. http://bigthink.com/ideas/17404
Be prepared. Her description of dopamine functioning and the reward circuitry will more closely match Naomi Wolfe’s “pseudoscientific” description. Hopefully you can get past that.

From that study:
—————————————For more than half a century, since the beginning of formal diagnostics, our psychiatric nosology has compartmentalized the compulsive pursuit of substance (e.g., alcohol, cocaine, heroin, nicotine) from nonsubstance (e.g., gambling, food, sex) rewards. Emerging brain, behavioral, and genetic findings challenge this diagnostic boundary, pointing to shared vulnerabilities underlying the pathological pursuit of substance and nonsubstance rewards. This review discusses how neurobiological data from problem gambling, obesity, and “normal” states of attachment (romantic infatuation, sexual attraction, maternal bonds) may help us in the task of carving addictions “at a new joint.”
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As far as being interested in “tantra”, a lot of people are interested in the neurobiology of various sexual behaviors including porn addiction. The author of this post (Vaughanbell) has taken hallucinogens and blogged about it. Should we discount what he has to say?

Well, Glarion, that’s quite a bit of bluster and data dumping you’ve made there, but as you’ll find, I’m not easily intimidated by bullshit artists and pseudoscientists. As to hallucinogen use, there’s a big difference between people like Vaughn Bell (and myself) who have tried them and find some interesting points of departure into neurology, versus, say, a Terence McKenna or John C. Lilly who tries to build an entire theory around spiritual revelations.

And it is pretty clear that the latter is the category you two (Robinson/Philo and Wilson/Glarion) fall into, with even the most cursory look at the theories expounded in Robinson’s book “Cupid’s Poisoned Arrow“. This book makes the rather tall claim, based on the odd theories of Tantric sexology, that orgasm is physically harmful, and that there is supposedly some sort of neuroscientific basis for this idea. These oddball views of the neuropsychology of sex dovetail into to the view that masturbation is harmful, and the current atmosphere of panic and pseudoscientific claims around pornography provide a wedge issue to espouse what would otherwise be seen as some very fringe ideas on sexuality.

It is quite clear on the very face of it that Naomi Wolf was espousing a “marijuana leads to heroin” view of pornography use, based on a very simplistic “dopamine is dangerous” framing of neuroscience, and I commend Bell for calling it out. As with similar false claims about the role of oxytocin, making such claims about the role of dopamine is irresponsible, alarmist, and deployed in the service of a larger agenda.

I will note, Glarion, that you have a clear advantage over most commentators here, myself included, in that you are better versed in the minutiae of the literature on dopamine, and it allows you to make some specific claims that are not easily challenged. However, one does not need to go very far into the claims the two of you make in your writing to note that your are prone to making very grandiose leaps of logic based on very specific and limited studies. I’ve seen enough pseudoscientists who use this technique of obfuscation to recognize it in action, and it is clear that you are doing it here.

Actually you do appear easily intimated, as you are not debating the content of our posts. It’s not your fault, as none of the current research supports Vaughanbell’s assertions. At this point in the debate you are taking on the top researchers in the addiction field, not me.

Instead, you cherry-pick material from the “Reuniting” site, so that you can avoid discussing the merits of our posts here. “Reuniting” is for those interested in both traditional sexual wisdom from many cultures and the intriguing modern neuroscience findings that may lend support to that wisdom. We created http://www.yourbrainonporn.com to separate the porn material from the sexual-relationships material. Two different audiences, 2 different sets of material. What you are trying to do is take science and experience-based content addressed to porn addicts (YBOP) and mix it in a misleading way with content related to tantric traditions (as you simplistically characterize them). I understand your resorting to this sleight of hand. After all, there is so much annoying, solid data to be found at yourbrainonporn.com.

Not trying to intimidate you, blue, just trying to steer you to the actual debate on Vaughanbell’s misleading use of science. To recap, there’s lots of bluster about how vaughanbell is correct and Naomi is misguided, but no specifics. One problem: the “data dumping” and “expert quotes” refute blog Vaughanbell’s post. I know, I know, “screw data when it gets in the way of a cherished opinion.”

Our page you cite was written for those practicing tantra traditions – that’s why it’s on the Reuniting site. Talk about cherry-picking. We never say masturbation is evil, or any nonsense like that. How ironic is it that we run a site (yourbrainonporn.com), which helps men recover from porn-induced ED so they can masturbate and have orgasms with real partners? We cheer them on as they return to full erectile (brain) health and resume orgasmic sex (not tantra) with real partners. That’s the part of the story you don’t want to touch.

Speaking of masturbation: Most of the men who wash up on our sites have porn-induced ED. They are the ones in a panic. They masturbated happily to porn for years. Now, after a few years of Internet porn, they can’t get it up for the real deal. Experts (and para-academics) say it’s all in their heads. They are half right – it’s an addictive process occurring in the brain’s reward circuitry, not a performance issue. (Some of these guys can’t even get it up now for solo sex.)

It’s true that the men have to understand the science behind their symptoms, stop porn and drastically reduce masturbation for a few months in order to return their brains to normal sensitivity. Once they heal, they are back in saddle and can have sex with real partners—or even experiment with other approaches to sex. Contrary to your spin, we encourage them to masturbate once their penises return to full strength. Above all, we encourage them to find balance (a word that may no longer be in your vocabulary). Incidentally, we were intrigued to find that today’s standard advice encouraging masturbation to Internet porn ad libitum is supported by neither anthropology, evolutionary biology nor the biology of sperm production. Alarmingly, today’s sexperts are not studying any of those fields.

Only in a very twisted worldview would masturbating to a screen with a limp penis be declared “sex positive” (what you are defending), while recovering the balance needed for healthy erections, strong libido and sex with a real partner be “sex negative.” We promote the latter. What are you advocating?

By the way, thanks for your opinion of our book. You may find it interesting (and revolting) that it is endorsed by three experts in the field of biology and neurobiology:
-AJ Reid Finlayson, MD, Division of Addiction Medicine professor, Vanderbilt University
-Russel Razzaque, MD, Consultant Psychiatrist (meaning he has an additional degree in neurobiology), London, England
-Jay Phelan, PhD, UCLA professor, co-author of “Mean Genes,” and author of a university biology textbook.

It seems the more neuroscience you know, the more our material makes sense.

We have already stated how Vaughanbell misled readers. We have backed it up with expert statements and research. I’ll be back when you do the same, or begin to discuss the specifics of this blog post.
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WARNING! More (highly relevant) data dump: The first link is to a talk by a well known addiction expert that refutes Vaughanbell’s spin. The next 3 studies refute Vaughanbell’s assertion (just like the many already posted) that that drug addiction employs different mechanisms from natural rewards. The last 3 studies found brain changes in Internet addicts that mirror those found in drug addicts.

NPR’s interview with noted research neurobiologist David Linden. In this 30-minute ‘Fresh Air’ segment, Dr. Linden states that that sex can be an addiction. Like Nora Volkow, his wording and descriptions of the reward circuitry, dopamine’s function parallel Naomi Wolf’s, not Vaughanbell’s.‘Compass Of Pleasure’: Why Some Things Feel So Good– http://www.npr.org/2011/06/23/137348338/compass-of-pleasure-why-some-things-feel-so-good
————- Is there a common molecular pathway for addiction? Nat Neurosci. 2005 Nov;8(11):1445-9, Nestler EJ. Drugs of abuse have very different acute mechanisms of action but converge on the brain’s reward pathways by producing a series of common functional effects after both acute and chronic administration. Some similar actions occur for natural rewards as well. Researchers are making progress in understanding the molecular and cellular basis of these common effects. A major goal for future research is to determine whether such common underpinnings of addiction can be exploited for the development of more effective treatments for a wide range of addictive disorders.

Reward Circuitry Dopaminergic Activation Regulates Food And Drug Craving Behavior.
Curr Pharm Des. 2011;17(12):1158-67. Neural circuits implicated in drug conditioning, craving and relapse overlap extensively with those involved in natural reward and reinforcement like food. Similar regional activation patterns occur in humans in response to cues associated with foods. Furthermore, drug- and food-related cues not only activate common neuroanatomical regions but also result in similar activity-regulated gene expression programs within these shared areas.

The Neuroscience of Natural Rewards Relevance to Addictive Drugs
The Journal of Neuroscience, 1 May 2002, 22(9): 3306-3311; Addictive drugs act on brain reward systems, although the brain evolved to respond not to drugs but to natural rewards, such as food and sex. In a quirk of evolutionary fate, humans discovered how to stimulate this system artificially with drugs. Many molecular features of neural systems instantiating reward, and of those systems affected by addictive drugs, are conserved across species
—————Reduced Striatal Dopamine D2 Receptors in People With Internet Addiction, Neuroreport. 2011 Jun 11;22(8):407-11. An increasing amount of research has suggested that Internet addiction is associated with abnormalities in the dopaminergic brain system. Consistent with our prediction, individuals with Internet addiction showed reduced levels of dopamine D2 receptor availability in subdivisions of the striatum including the bilateral dorsal caudate and right putamen. This finding contributes to the understanding of neurobiological mechanism of Internet addiction.

Microstructure Abnormalities in Adolescents with Internet Addiction Disorder. Our results suggested that long-term internet addiction would result in brain structural alterations, which probably contributed to chronic dysfunction in subjects with IAD

Having read the posts that you and your colleague/friend Philo have posted, and having had a good conversation with Philo about the points you are both raising, I can see why you are so concerned about this issue. Clearly, and evidently from your website and the men you have had contact with, some men do seem to have problems with porn. I think that “porn addiction” is a very vague term, as its hard to define exactly when indulging in something you like becomes an addiction. However, erectile dysfunction (ED) is a clear and physical symptom, so lets discuss that a little.

I think there are a few points that need to be researched more, in order to determine how prevalent a problem this is for men in the internet age. Specifically, I think the following research needs to be conducted:

1) How common is ED in porn using men? Is it a problem that 10% of porn users have, or 1%? Because masturbation and pornography are taboo subjects to discuss in our society, its hard for us to tell this anecdotally. You could questionnaire the men that visit your website, but this would be a bit of a biased sample, as men visiting that site are possibly far more likely than average to have a problem with porn (perhaps). To get around the problems of a biased sample, we’d need to questionnaire men from a variety of groups, probably through a porn forum or other forum where there are lots of men. Just to repeat, we need to know if this is a very common problem caused by internet porn (30%), or if it just affects minority of men (10%) or a very small minority (1%)

This is good evidence of receptor abnormality in people who have problematic internet use. Unfortunately the article is behind a paywall (can you get this Vaughan?) so we can’t tell if the internet addiction is due to pornography, games like World of Warcraft, or social network sites like Facebook (or a combination of all of those). Your point about this is still valid though, that there are abnormalities in the brains of people with internet addiction (however the authors define this).

However, the abstract says: “An increasing amount of research has suggested that Internet addiction is [b]associated[/b] with abnormalities in the dopaminergic brain system.”

Associated is the key word here. We can’t conclude that internet use is *causing* receptor downregulation. It might be, but it could also be that people with diminished D2 receptors are more likely to become addicted to internet use, or that a third factor is causing both effects. This is a critically important point in all neuropsychological and/or cognitive neuroscience studies – does the brain abnormality cause the behaviour, or is the behaviour causing a brain abnormality?

3) Another thing that is critically important in psychology, is that behaviours are basically never caused by one factor acting alone. If this were the case, then psychologists like Vaughan and I would easily be able to predict people’s future behaviours (and we’d probably be very rich as a result). Instead there are multiple biological, psychological and sociological causes (and effects) of behaviours.

In relation to porn addiction, lets assume that you or some other researcher has done the research I suggest in point 1 above, and determined that 12% of men suffer from porn addiction to the point where they have ED in their real life sexual relationships. This would represent a large and significant minority of men (given that about 90% of men watch porn) and would be a health problem that should not be ignored. But could we easily conclude that the porn is causing the problem?

Well, in that situation, given that 88% of our sample didn’t have the problem, we’d probably conclude that there are other factors, as well as the porn, that are involved causally. Do these 12% of men have other addiction problems? Do a large proportion of them suffer from ADHD? Are a large proportion of them single, with no real life sexual relationships? Are a proportion of them sex offenders who need a safe outlet? Have any of them suffered a frontal lobe brain injury? (common following car crashes) which can cause problems with self control. Finally, did some of these men have ED prior to developing a porn addiction?

4) Finally, I think we need to consider again what is common, and what is different about about addictions and the involvement of dopamine. Sure, dopamine is common to all reinforcement of behaviours, and probably evolved to be used in that way because dopamine is critical to movement (as people with Parkinson’s disease discover). However, its not as simple as dopamine=addiction, which was the point that I feel Vaughan was originally trying to make.

Parkinson’s patients don’t become addicted to L-Dopa medication (although it often boosts their sex drive). People can develop eating addictions and disorders, but not all people do. I suspect that porn is similar to food in this respect.